Asymptomatic Bacteriuria during Pregnancy with Special Reference to Group B Streptococci

Persson, Kristina; Christensen, Karen Kvist; Christensen, Poul; Forsgren, Arne; Jörgensen, Connie; Persson, Per‐Håkan

doi:10.3109/13813458509061666

Cited by 20 publications

(36 citation statements)

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“…While the overall prevalence of GBS UTI in the adult population remains unclear, GBS bacteriuria during pregnancy occurs at rates of between 1 and 3.5% (4,23,41). Many of these episodes represent ABU (2, 18); however, GBS ABU is considered to be a surrogate for heavy maternal colonization (29,42) and is currently recommended for intrapartum antibiotic chemoprophylaxis (23,34). In addition, up to 7% of pregnancies may be complicated by GBS UTI, and GBS reportedly accounts for approximately 10% of all cases of pyelonephritis during pregnancy (25,28).…”

mentioning

confidence: 99%

Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults

Ulett¹,

Benjamin

Zhuo

et al. 2009

J Clin Microbiol

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Serotypes of group B streptococcus (GBS) that cause urinary tract infection (UTI) are poorly characterized.We conducted a prospective study of GBS UTI in adults to define the clinical and microbiological characteristics of these infections, including which serotypes cause disease. Patients who had GBS cultured from urine over a 1-year period were grouped according to symptoms, bacteriuria, and urinalysis. Demographic data were obtained by reviewing medical records. Isolates were serotyped by latex agglutination and multiplex PCRreverse line blotting (mPCR/RLB). Antibiotic susceptibilities were determined by disc diffusion. GBS was cultured from 387/34,367 consecutive urine samples (1.1%): 62 patients had bacteriuria of >10 7 CFU/liter and at least one UTI symptom; of these patients, 31 had urinary leukocyte esterase and pyuria (others not tested), 50 (81%) had symptoms consistent with cystitis, and 12 (19%) had symptoms of pyelonephritis. Compared with controls (who had GBS isolated without symptoms), a prior history of UTI was an independent risk factor for disease. Increased age was also significantly associated with acute infection. Serotyping results were consistent between latex agglutination and mPCR/RLB for 331/387 (85.5%) isolates; 22 (5.7%) and 7 (1.8%) isolates were nontypeable with antisera and by mPCR/RLB, respectively; and 45/56 (80.4%) isolates with discrepant results were typed by mPCR/RLB as belonging to serotype V. Serotypes V, Ia, and III caused the most UTIs; serotypes II, Ib, and IV were less common. Nontypeable GBS was not associated with UTI. Erythromycin (39.5%) and clindamycin (26.4%) resistance was common. We conclude that a more diverse spectrum of GBS serotypes causes UTI than previously recognized, with the exception of nontypeable GBS.Group B streptococcus (GBS) is a leading cause of infection in newborns, pregnant women, and older persons with chronic medical illness (3,8). In addition to maternal cervicovaginal colonization and neonatal infection that results from the vertical transmission of bacteria from mothers to their infants, GBS can also cause urinary tract infection (UTI). The spectrum of GBS UTI includes asymptomatic bacteriuria (ABU), cystitis, pyelonephritis, urethritis, and urosepsis (6,8,10,20,23,26). GBS ABU is particularly common among pregnant women, although those most at risk for cystitis due to GBS appear to be the elderly and immunocompromised individuals (8,9,25). Despite the uropathogenic nature of GBS, the clinical and microbiological features of GBS UTI, including risk factors for disease and whether there is a tendency for particular GBS serotypes to cause UTI, are poorly understood.Clinically, UTI due to GBS may be indistinguishable from UTI caused by other uropathogens (25). However, a recent study of multiple uropathogens and host characteristics highlighted unique frequencies of host characteristics in UTI groups defined by the causal organism (37). This suggests that the clinical and microbiological features of UTI may differ depending on the infecting...

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mentioning

confidence: 99%

Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults

Ulett¹,

Benjamin

Zhuo

et al. 2009

J Clin Microbiol

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“…MS and antisera-based serotyping was used in one study to identify the serotypes associated with UTI (Ulett et al, 2009), and demonstrated a predominance of serotypes Ia, II, III, and V in patients with acute UTI. Other studies demonstrated that nontypeable GBS also cause acute UTI (McKenna et al, 2003, Persson et al, 1985.…”

Section: Diagnosis Of Gbs Utimentioning

confidence: 99%

“…Finally, although pregnant women may receive antibiotics to treat GBS ABU this therapy may not eliminate GBS from the genitourinary tract, and recolonization after a course of antibiotics can occur (Baecher&Grobman, 2008, Gardner et al, 1979, Hall et al, 1976. Most data on the risk for EOD among infants born to women with GBS ABU are derived from studies using thresholds >10 5 cfu/ml despite lower counts of 10 3 cfu/ml having been associated with acute GBS UTI (Persson et al, 1986b, Persson et al, 1985, Ulett et al, 2009, Wood&Dillon, 1981. Although low concentrations (10 3 -10 4 cfu/ml) of GBS in urine can be associated with colonization (Centelles-Serrano et al, 2009) limited data support the risk for EOD among infants born to women with low colony-count GBS ABU (Persson et al, 1986a).…”

Section: Gbs Abu and Uti In Pregnancymentioning

confidence: 99%

Current Understanding of Streptococcal Urinary Tract Infection

Tan¹,

Carey²,

Ipe³

et al. 2011

Clinical Management of Complicated Urinary Tract Infection

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“…18 A sample of urine should also be analysed in the third trimester, since GBS bacteriuria is associated with exposure of the fetus to a high bacterial load. 19 For screening to be effective, a method of culture must be employed that is both sensitive and specific. Standard bacteriological swabs plated directly on to agar fail to detect GBS in up to 50% of colonised women.…”

Section: Universal Prenatal Screeningmentioning

confidence: 99%

Group B streptococcal disease: screening and treatment in pregnancy

Malek

Embleton

Loughney

2005

The Obstetrician &Amp; Gynaecologist

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Intermittent, asymptomatic colonisation of the vagina and rectum with group B streptococci is common in pregnancy. Vertical transmission of the bacterium from mother to fetus may lead to neonatal sepsis, characterised by pneumonia, meningitis and death in the most severely affected babies. Intrapartum prophylaxis with penicillin reduces the burden of disease when given to women with risk factors for the development of group B streptococcal sepsis such as preterm labour, prolonged rupture of the membranes or maternal pyrexia in labour. Some professionals advocate the universal screening of all pregnant women for group B streptococci near term and the administration of intrapartum antibiotic prophylaxis to all women testing swab‐positive. This article summarises the salient features of group B streptococcal disease and explores the rationale behind the use of intrapartum antibiotics for the prevention of neonatal infection.

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Asymptomatic Bacteriuria during Pregnancy with Special Reference to Group B Streptococci

Cited by 20 publications

References 0 publications

Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults

Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults

Current Understanding of Streptococcal Urinary Tract Infection

Group B streptococcal disease: screening and treatment in pregnancy

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